Rethinking dual-task training in Parkinson's disease: Engaging and innovating for inclusive access to rehabilitation

Dual-task training helps improve balance and cognitive function in people with Parkinson's disease, but existing clinician-led, clinic-based programmes lack standardization. This qualitative study aimed to inform new programme designs by exploring the experiences and needs of individuals with Parkinson's disease, their supporters, and physiotherapists. Semi-structured interviews were conducted with ten participants - six with mild-to-moderate Parkinson's disease, two supporters, and two physiotherapists. Interviews were recorded, transcribed, and independently analysed by two researchers using framework analysis. Three main themes emerged: what comprises "An Engaging Dual-task Training," emphasizing enjoyment, daily life integration, and the need for a balance between challenge and reward as well as the effectiveness of the task to be known; the impact of "Home-Based Dual-task Training," discussing the pros and cons of home-based training and technology use, and the opportunity to engage supporters as training buddies; the need for "Acceptable Assessment Options," exploring hybridization of the use of remote and clinic-based assessment methods. Participants valued traditional, clinic-based, clinician-supervised rehabilitation, while also supporting home-based adjunctive programmes for their potential to offer greater autonomy, flexibility, cognitive engagement, and inclusive integration into daily life.